PLAN LEARN EXPLORE COMPARE DECIDE RETIREES. Page Info Name 1

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1 PLAN LEARN EXPLORE COMPARE DECIDE RETIREES Page Info Name 1

2 CONTENTS PLAN 3 Introduction 5 Building a Healthy Community LEARN 7 What is Open Enrollment? 8 What s Staying the Same for 2017? 8 What's New and What's Changing for 2017? 10 Plan Features 12 How to Utilize Your Care 14 Retiree Health Savings Plan 15 Retiree Health Savings Account Healthy Habits of a Good Healthcare Consumer COMPARE 22 Comparing the Medical Plans 25 Your Prescription Drug Benefits 27 Choosing a Medical Plan 28 Your Vision Coverage Options 30 Your Dental Coverage Options 32 Life Insurance 33 Dental Coverage Rates 33 UHC Vision Coverage Rates DECIDE 35 How to Enroll 36 Important Contact Information EXPLORE 19 Explore Ways to Tour Open Enrollment Information 20 Fight the Flu for a Healthier GW 2 Table of Contents

3 START PLANNING What: WHAT: Mark your calendar for Open Enrollment, the annual opportunity for you to make health and welfare benefits changes and to add or drop coverage for eligible dependents. And, be sure to bookmark the Benefits Open Enrollment website your destination for all employee open enrollment benefit-related information! Who: WHO: All GW faculty and staff retirees and their eligible dependents. When: WHEN: November 1 through 15 Why: WHY: Even if you are happy with your elections from last year, it s always a good practice to review and confirm that you ve signed up for the right plan for you and your family. If you choose not to take action, coverage will either roll over or default into a new plan.* So take the time to review your options; otherwise, you ll have to wait until the next Open Enrollment period unless you experience a qualified life event (such as getting married, having a baby) to make changes. *The cost of the coverage will reflect 2017 contribution amounts. Changes of Address or Personal Contact Information Please be sure to provide your current address and phone number to PayFlex. We periodically mail information to retirees, and may be unable to contact you without this information. In the event that you relocate in the future, please be sure PayFlex is notified of your new address and any change to your phone number. Contact: PayFlex ATTENTION: The Retiree Choice Plus Basic plan will be discontinued, and replaced with the Retiree Health Savings Plan (HSP). If you are in the Basic plan and you do not update your medical election, you ll be defaulted into the new Retiree HSP. You have two weeks to complete your Open Enrollment elections. For more information, see page 22. Start Planning 3

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5 BUILDING A HEALTHY COMMUNITY Over the years, GW has been working proactively to help employees and retirees get on a path toward improved health and wellness by implementing a number of strategies: Preventive Care and Telemedicine 100% of preventive services are covered in network for those enrolled in the UHC medical plans. Telemedicine, also referred to as Virtual Visits, was introduced in 2016 and provides participants convenient access to providers to assist with a wide range of conditions and questions, getting the help and prescriptions they need while avoiding the waiting room! Financial Fitness Retirement consultants from Fidelity and TIAA are available on campus and at their local offices by appointment to assist with: understanding the plans and available investments, creating individualized plans and reviewing account balances. Learn more by visiting: Building a Healthy Community 5

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7 WHAT IS OPEN ENROLLMENT? Open Enrollment is your annual opportunity to reflect on your and your family s needs and fine tune your benefits package to match. Many life events can occur over the course of the year that can impact the types of plans and amount of coverage you need. Take this opportunity to think about the changes you and your family have experienced in the past year, or anticipate in the coming year. Then, determine which benefit plans and programs will best meet your needs. WHAT S INCLUDED? The benefits below are part of Open Enrollment, which will run November 1 through 15 and can only be changed once per year unless you have a qualified life event: Benefit Retiree Choice Plus Basic plan (including pharmacy) Retiree Health Savings Account Blue 65 PPO (including pharmacy) What you ll have in 2017 if you don t act during Open Enrollment: You will be automatically enrolled in the NEW! Retiree HSP. If you enroll in the Retiree HSP, you may open a Health Savings Account (HSA) at the institution of your choice at any time during the year. Dental Plan Vision The same plan you have now. Life Insurance These benefits are part of Open Enrollment, and can only be changed once per year unless you have a qualified life event. Open Enrollment and What's Included 7

8 WHAT S STAYING THE SAME FOR 2017 For Retirees and their dependents who are age 65 or older or Medicare eligible, GW will continue to offer the UHC Blue 65 PPO plan. There are no changes to the premiums, deductibles, or benefits of this plan. Pharmacy Coverage If you participate in one of GW s health plan options, you will continue to have pharmacy coverage through CVS Caremark. There will be no changes to the plan coverage including coinsurance amounts. Dental and Vision Good dental and vision care contribute to overall health and wellness, and both continue to be part of our comprehensive healthcare benefits. Costs will increase slightly for the High and Low dental PPO plans, while the DMO dental plan, Basic and Enhanced Vision plans will have no changes to employee contributions. There will be no changes in plan coverage. Free-Standing Imaging and Labs Prices vary significantly for imaging and lab work even if you go in-network! The Retiree HSP will continue to offer a preferred network including a lower coinsurance when you use a freestanding network facility instead of a hospital for labs, X-rays and major diagnostics Tuition Remission As a GW retiree you are eligible for tuition remission benefits. There will be no changes to these programs for For more information please visit WHAT S NEW AND WHAT S CHANGING FOR 2017 Information about the new 2017 benefit programs and changes is outlined below. For details on plan coverage, please review the plan comparison chart beginning on page 27. Here are the highlights of the changes and details: NEW! Retiree Health Savings Plan (HSP) with Health Savings Account (HSA) for Pre-Medicare Retirees and Dependents Basic Plan Discontinued The GW Retiree HSP covers in- and out-of-network services (you ll pay more for out-of-network providers). In-network preventive services and medications are covered at 100%. For retirees and their dependents who are under 65 years of age or who are not Medicare eligible, the Retiree Choice Plus Basic Plan will be discontinued and replaced with the GW Retiree Health Savings Plan (HSP) with Health Savings Account (HSA). This plan is designed to give you control over your healthcare dollars and save for your future. It is a lower-premium, high deductible health insurance plan, which means you pay less out-of-pocket each month and more at the point of care. For all other services, you are responsible for paying the full cost of care until you reach the plan s deductible. You are then responsible for a portion of the cost of care (your coinsurance) until you reach the plan s out-of-pocket maximum If you or your dependent(s) are currently enrolled in the Retiree Choice Plus Basic Plan, you will be moved to the GW Retiree HSP, unless you waive benefits for If you choose to do nothing, you will be defaulted into the NEW Retiree HSP PPO. The network for the HSP is identical to the Choice Plus Basic Plan, and there is no need to designate a Primary Care Physician or to obtain specialist referrals. 8 What's Staying the Same, What's New and What's Changing for 2017

9 MORE OF WHAT S NEW AND WHAT S CHANGING FOR 2017 Health Savings Account (HSA) The HSA contribution limit: For those with individual Retiree HSP coverage, the limit $3,400. The family limit is $6,750 or; If you are age 55 or older there is an additional $1,000 catch up allowed. NEW! Acupuncture Acupuncture will now be covered under both the Retiree HSP and Blue 65 PPO up to 20 visits per year. (combined in- and out-of-network). NEW! Transgender Coverage GW will add coverage for surgery and commonly used medications for gender reassignment. BlueStar The GW prescription plans now cover a new digital therapy for adults living diagnosed with type 2 diabetes. The digital therapy is called BlueStar and enables personalized coaching based on your individual treatment plan, through the use of your cell phone and/or computer. BlueStar is a prescribed therapy. To learn more, please contact a BlueStar Customer Care representative at Centers of Excellence In 2017 GW will offer UHC's Centers for Excellence for Cancer. These Centers of Excellence provide access to leading healthcare facilities, physicians and services to support safe, specialized and cost-effective care. UHC s nurse consultants provide the information you need to make informed decisions about your care and help guide you to a Centers of Excellence Networks program that meets your specific needs. NEW! Online Middle and High School Tuition Discount Beginning September 15, 2016, retirees, along with their extended family, may enroll students in grades 6 12 in the George Washington University Online High School (GWUOHS) through an exclusive 20% off tuition discount. This benefit may be applied to enrollment in either the full-time, diploma-granting program or part-time AP courses.* Retirees and their extended family may take advantage of this discount at any time during the year regardless of when the GW Open Enrollment window occurs. Visit gwuohs.com/discount for more information or to begin the enrollment process. * Discount may not be combined with any other offer or discount. What's New and What's Changing for

10 PLAN FEATURES Benefits have a language all their own. Understanding how your insurance plans work is something everyone needs to understand to make the most out of your coverage. Know Before You Go Become familiar with these commonly used benefits terms to help you compare plans and decide! Total Out-of-Pocket Costs Here s a simple equation that shows how much you ll pay out-of-pocket for your health insurance each year. PREMIUMS + DEDUCTIBLE + COPAYS & COINSURANCE (UP TO THE OUT-OF-POCKET MAXIMUM) TOTAL RETIREE COSTS Once you meet your plan's Out-of-Pocket Maximum, the plan pays 100% of your covered medical expenses for the balance of the year. PREMIUMS: The amount you pay for your health insurance every month. DEDUCTIBLE: The amount you pay out-of-pocket for healthcare before plan starts to pay. (Please note, the deductible may not be applicable to all services. Please see page 25). Separate in-and-out of network deductibles apply. COPAYS: A set amount (for example, $30) you pay for a covered healthcare service. COINSURANCE: The percentage you pay for the cost of covered healthcare services, after you meet your deductible. OUT-OF-POCKET MAXIMUM: This is a cap on your costs for the year; it is the most you ll pay for healthcare services. Once you reach your out-of-pocket maximum, the plan pays 100% of your covered medical expenses for the balance of the year. Separate in- and out-of-network out-of-pocket maximums do apply. Understanding your Deductibles Your deductible is tied to your premium. Just like car insurance, a plan with a low deductible will cost you a higher premium. On the flip side, a health savings plan with a higher deductible will have a lower premium. 10 Plan Features

11 Decoding your Deductible Not all deductibles are created equal. Here are a couple of common types:. Network Deductibles GW s health plans have separate annual deductibles for when you get in-network care and out-of-network care. These are usually different for individuals and families. Family Deductibles With some plans, you ll need to meet the deductible for each covered family member up to the family cap. For example, under the Blue 65 PPO, each person will need to meet the in-network individual deductible of $500 (capped at $1,000 per family). Once an individual meets the $500 deductible, coinsurance begins for that person. Note, the deductible for the Blue 65 PPO includes medical expenses only. With the Retiree HSP, one family member can meet the deductible for the entire family. For example, if you elect coverage for yourself and one or more dependents, the full family deductible (in-network family deductible is $4,000) will need to be met before coinsurance begins for any family member. Remember, the Retiree HSP deductible includes both medical and pharmacy expenses. When you cover your family, review your family deductible closely. Glossary of Terms Covered Services: Those services deemed by your plan to be medically necessary for the care and treatment of an injury or illness. Formulary: Sometimes referred to as a preferred drug list, a list of prescription medications that are covered by a pharmacy plan. Drugs not on a formulary may not be available, may carry a higher cost-share amount or may be accessible only with prior authorization. Generic: An FDA-approved drug, composed of virtually the same chemical formula as a brand-name drug. Ask for generics! Generic medications contain the same active ingredients as brand-name drugs but cost less. Talk to your doctor about getting generics and making sure medications are on your plan s formulary. Specialty Drugs: Low-volume, high-cost medication prescribed for chronic and complex illnesses such as multiple sclerosis, hepatitis C and hemophilia as well as some common diseases such as rheumatoid arthritis. Specialty drugs often require special storage and handling and are not readily available at the typical local retail pharmacy. High Deductible Health Plan (HDHP): A plan with a higher deductible than a traditional insurance plan. These plans typically have lower monthly premiums but you must pay more out of pocket initially (your deductible for pharmacy and medical) before the plan starts to pay. A HDHP can be combined with a health savings account. This allows you to pay for certain medical expenses with pretax dollars. (The GW Retiree HSP is considered one of these plans.) Network: A group of doctors, labs, hospitals and other providers that your plan contracts with at a set payment rate. Preventive Care: Preventive care services include services that help you manage your health, such as routine physical exams, screenings and lab tests these are all covered at 100% by the GW health plans, with no out-of-pocket costs like deductibles or copays as long as the services are received in-network. Be sure your provider codes the services as preventive. Preferred Provider Organization (PPO): A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan s network. You can use doctors, hospitals and providers outside of the network for an additional cost. Going Digital for Health! Did you know that the GW pharmacy programs now cover a new digital therapy for adults living diagnosed with type 2 diabetes? The digital therapy is called BlueStar and enables personalized coaching based on your individual treatment plan, through the use of your cell phone and/or computer. BlueStar is a prescribed therapy. To learn more, please contact a BlueStar Customer Care representative at Plan Features and Glossary 11

12 HOW TO UTILIZE YOUR CARE How Prescription Coinsurance Works Coinsurance is your share of the costs of a covered healthcare service, calculated as a percent (for example, 20%) of the cost for the service or prescription drug. GW pays the rest of the cost. For those on the Blue 65 PPO There is financial protection built into the prescription drug benefit in that you will never pay more than the maximum, outlined in the table below. In addition, once you reach the out-of-pocket-maximum, GW pays 100% of prescription drug costs. George George is enrolled in the Blue 65 PPO. He isn t feeling well so he goes to his primary care physician. He has bronchitis and his physician recommends a prescription antibiotic as treatment. George asks his physician if he can prescribe a generic antibiotic. Martha Martha is also enrolled in the Blue 65 PPO and does not feel well. Martha goes to her primary care physician and also has bronchitis. Her physician writes her a prescription for a preferred brand antibiotic with a similar chemical formula to the antibiotic George received. She gets to the pharmacy and finds out the total antibiotic cost is $400. Generic Coinsurance 10% Maximum $30 Cost of Drug $160 GEORGE PAYS $16 GW Pays $144 Preferred Brand Coinsurance 20% Maximum $50 Cost of Drug $400 MARTHA PAYS $50 GW Pays $350 For those on the Retiree HSP: You must pay all costs for prescription drugs until you meet your annual deductible. Remember, your pharmacy deductible is combined with your medical deductible. After you meet your deductible, you will be responsible for coinsurance until you reach the out-of-pocket maximum. Remember: You can use your HSA to pay for eligible out-of-pocket costs, including your deductible and prescription coinsurance. Retiree HSP participants, remember: Preventive medications are covered at 100%! Coinsurance and deductible do not apply. 12 How to Utilize Your Care

13 Save Money by Using Freestanding Facilities Prices vary significantly for imaging and lab work even if you go in-network. Not only do prices vary, but if you participate in the Retiree HSP, you will pay a lower coinsurance when you use a freestanding network facility instead of a hospital for healthcare services or treatments that do not require an overnight hospital stay. A freestanding facility performs outpatient services and submits claims separately from any hospital affiliation. The Retiree HSP offers a preferred network for labs, X-ray and major diagnostics. When you go to a preferred network freestanding facility for these services, you will pay 20% coinsurance for the HSP plans. If you go to a facility that is not in the preferred network you will pay 40% coinsurance. LabCorp will remain the preferred vendor for lab work. When you do need outpatient lab tests and imaging, refer to the checklist below of what to ask. Visit go.gwu.edu/preferred for directions on how to compare costs and locate a preferred provider for networks and labs. Average costs of imaging and diagnostic services Selected Imaging, X-Ray, Major Diagnostic Service MRI Scan Ultrasound Abdomen General Blood Health Panel Test PET Scan with CT Scan In-Network Free Standing Facility Total Cost / Member Cost (20% Coinsurance)* Total - $559 Member - $112 Total - $114 Member - $23 Total - $15 Member - $3 Total - $539 Member - $108 Hospital Total Average Cost / Member Cost (40% Coinsurance)* Total - $1,087 Member - $435 Total - $323 Member - $129 Total - $21 Member - $8 Total - $730 Member - $292 When using outpatient lab tests and imaging, ask: Do you know the cost of the tests you are ordering? Is the provider or laboratory in my network? Since my share of the cost is less for services performed in a freestanding facility that is not connected to a hospital, can the test or service be performed at a freestanding facility? Can you recommend a freestanding facility in the UnitedHealthcare network? (Your doctor can access a list of participating laboratories by visiting *Coinsurance after deductible has been met How to Utilize Your Care 13

14 RETIREE HEALTH SAVINGS PLAN The Retiree Health Savings Plan (HSP) with Health Savings Account (HSA) is designed to give you control over your healthcare dollars and save for your future. It is a lower-premium, high deductible health insurance plan, which means you pay less out-of-pocket each month and more at the point of care before the plan pays for services that are not considered preventive. There is no need to designate a Primary Care Physician or to obtain specialist referrals. The Retiree HSP covers in- and out-of-network services (you ll pay more for out-of-network providers). For all other services, you are responsible for paying the full cost of care until you reach the plan s deductible. Then you are responsible for a portion of the cost of care (your coinsurance) until you reach the plan s out-of-pocket maximum. In-network preventive services and medications are covered at 100%. 14 GW Retiree Savings Plan

15 RETIREE HEALTH SAVINGS ACCOUNT When you are covered by a high deductible health plan like the Retiree HSP, you are eligible to participate in a Health Savings Account (HSA)*. Contribute to your HSA In 2017, you may contribute up to $3,400 if you have individual coverage, or up to $6,750 if you are covering yourself and additional family member(s). If you are age 55 or older, you may contribute an additional $1,000 to your account. Contributions to your HSA accumulate if not used. You may use the funds to pay for any qualified health expenses incurred after the account is opened. You may pay the bill directly via the HSA, or you may use the HSA to reimburse yourself for payments that you make. Payments and withdrawals made from your HSA to cover qualified healthcare expenses are tax-free. HSA is an investment tool An HSA is an investment tool that helps you save for healthcare expenses, including deductibles and coinsurance. Contributions to your HSA account are tax deductible, and any interest earned on the account is tax-free. Contribute Earn Interest Save Invest * Am I eligible for a Health Savings Account? To be eligible you must meet these few criteria: Be covered by a qualified HDHP (like the Retiree HSP) Cannot be enrolled in Medicare or TRICARE Cannot be claimed as a dependent on someone else s tax return Cannot be covered by another health plan that is not HSA-qualified GW Health Savings Account 15

16 0 HEALTHY HABITS OF A GOOD HEALTHCARE CONSUMER 1 Choose In-Network Providers UnitedHealthcare negotiates with providers and healthcare facilities for discounted fees. These providers make up the health plan s network. When 3 Time for a Check-Up Prevention and early detection of disease are the best ways to live a healthy life. A simple checkup could mean the difference between treating a you visit an in-network provider, you usually pay chronic condition for an indefinite amount of time a lower copayment, lower deductible and lower and making small lifestyle changes to prevent the coinsurance. Using an out-of-network provider can onset of disease. The better your health, the lower cost you more money out-of-pocket. your healthcare costs are likely to be. Preventive 2 Choose Generics Generic prescription medications are nearly identical to their brand-name equivalents in quality and composition, but generally cost much less due to the lower coinsurance. Every time you fill a prescription, health screenings are 100% covered by all GW health plans if you go to an in-network provider. Need a provider? Call Health Advocate, a GW-provided benefit, to help you navigate the healthcare system at you could be saving money by asking for a generic version of the medicine. The difference in cost can add up to big savings in a short time Healthy Habits of a Good Healthcare Consumer

17 Use the Emergency Room for Emergencies You will save money when you visit an in-network provider or walk-in clinic for routine ailments such as sore throats, colds, flu, earaches, minor back pain and tension headaches. If you are not sure if your condition requires a trip to the ER, call UHC s Nurseline any time day or night Choose Freestanding Facilities Choose in-network freestanding facilities for lab and imaging services and save. An MRI at a hospital can cost the plan more than $1,500 while the same MRI at a freestanding facility may cost only $500. Ask Your Doctor Questions Become an active participant in your healthcare and ask questions about all the services your physician recommends, including radiological services, hospital stays, lab tests, medications and anything else. Talk to your doctor and find out if a procedure is absolutely necessary. You could lower your healthcare costs by eliminating an unnecessary test or procedure. Visit healthadvocate.com/gwu to create a personal medical visit checklist. 10 Stay Healthy A great way to save money on your healthcare is to stay healthy! When you get regular exercise, eat healthy, drink plenty of water and avoid smoking or drinking too much alcohol, you re improving your health and reducing the likelihood of future health problems. Lowering your risk for future health problems not only improves your quality of life, it also lowers healthcare costs for you and the university. While tackling all of these at once could be difficult, taking the first step toward improving your health might be easier than you think. Skip the Waiting Room with Virtual Visits A virtual visit lets you see and talk to a doctor from your mobile device or computer, any time, without an appointment! Virtual Visits will cost you less than using an urgent care facility! It s offered to you as part of your GW health plan benefits. Log in to go.gwu.edu/virtualvisit or download the UnitedHealthcare Health4Me app at go.gwu.edu/health4me app to learn more about virtual visits. 7 8 Take advantage of an HSA With a health savings account (HSA), you choose to save pre-tax dollars for out-of-pocket medical costs. These accounts are great for covering expected and unexpected medical expenses and lowering your taxable income, which saves you money. Use Maintenance Mail Order for Prescriptions If you have a condition that requires ongoing prescription medication, you will have the lowest out-of-pocket costs possible by requesting that your doctor provide a prescription for a 90-day supply of your medication. Not only will you save money, you also save a trip to the pharmacy! BECOME A HEALTH CARE CONSUMER! Being an informed consumer is the best way to get the healthcare you need and the most value from your GW benefits. 10 Healthy Habits of a Good Healthcare Consumer 17

18 Plan Learn Explore Compare Decide EXPLORE EXPLORE 18 Page Info Name

19 EXPLORE WAYS TO TOUR OPEN ENROLLMENT INFORMATION Benefits Open Enrollment Office Hours Refer to the schedule of office hours on the right. Review Plan Details and Access Other Resources To review plan details and access other benefit resources online! Return completed and signed enrollment form to PayFlex by November 15, Office Hours During the Open Enrollment period, Benefits Administration staff will be available to answer questions and assist with your enrollment. Foggy Bottom Campus: Wednesday, November 9 10:00 a.m. 4:00 p.m. Marvin Center, Room 311 Virginia Science and Technology Campus: Friday, November 11 10:00 a.m. 4:00 p.m. Enterprise Hall, Room 175 Explore Ways to Tour Open Enrollment Information 19

20 Fight the Flu for a Healthier GW Flu season is here, and it s more important than ever for you to take care of your health. A flu shot can protect you against the seasonal flu, and other forms of the flu virus. Take a positive step to help reduce your chances of catching this season s viruses and get a flu vaccine. Flu shots are available at CVS/pharmacy, RiteAid Pharmacy, Target Pharmacy and Walgreens Pharmacy at no cost for faculty and staff who participate in any of GW s medical plans. This also includes your spouse/domestic partner and dependent children if they are covered under your GW retiree health plan. Just present your UnitedHealthcare card, and your shot is 100% covered. Benefits Open Enrollment Events 20

21 Plan Discover Learn Explore Compare Decide COMPARE 21 Page Info Name

22 For more details about your coverage options, read the Comparing the Medical Plans chart, which follows. Percentages in the accompanying chart represent the percentages of allowed benefit covered by the plan (GW) as well as the employee responsibility. COMPARING THE MEDICAL PLANS Note: The GW medical plan offerings use the UHC Choice Plus network. Retiree Health Savings Plan (HSP) Blue 65 PPO In-Network Out-of-Network In-Network and Out-of Network Deductible Individual $2,000 $3,000 $500 Family $4,000 $6,000 $1,000 Out-of-Pocket Maximum Individual $4,000 $6,000 $4,000 Family $7,150 $12,000 $8,000 Coinsurance Lifetime Maximum Office Visit Unlimited Unlimited PCP Specialist Virtual Visit Imaging and Labs Preferred Non-Preferred Diagnostic Test (x-ray, blood work) Imaging (CT/PET scans, MRIs) For family coverage, no one in the family is eligible for the coinsurance benefit until the family coverage deductible is met. Under Healthcare Reform all plans must have an out-of-pocket maximum. In addition deductibles, copays and coinsurance must apply to the OOP max. (Only allowed charges will count towards the OOP max for out-of-network benefits.) Preferred Network = in-network freestanding facilities and GW hospital Non-Preferred Network = in-network hospitals (other than GW Hospital) or out-of-network freestanding facilities or hospitals (in or out-of-network deductible applies as appropriate) Comparing the Medical Plans 22

23 Retiree Health Savings Plan (HSP) Blue 65 PPO In-Network Out-of-Network In-Network and Out-of-Network Hospital Care Inpatient Outpatient GW - 80% Urgent Care Emergency Room Preventive Mammography* 100% for one preventive mammogram per year, age 40 and over Pap Test* GW covers 100% if part of wellness exam GW covers 100% if part of wellness exam Prostate Exam* GW covers 100% if part of wellness exam GW covers 100% if part of wellness exam Well Child and Well Adult Exams* GW covers 100% GW covers 100% if part of wellness exam Chiropractic Care up to 60 visits per year (combined inand out-of-network) up to 60 visits per year (combined inand out-of-network) up to 60 visits per year Acupuncture up to 20 visits per year (combined inand out-of-network) up to 20 visits per year (combined inand out-of-network) up to 20 visits per year Hearing Aids** Not Covered Not Covered * Preventive care guidelines are based on recommendations of the U.S. Preventive Services Task Force and other health organizations. Visit for additional details on ALL preventive care guidelines based on your age and sex. ** Up to a single purchase (including repair/replacement) per hearing impaired ear every 36 months. 23 Comparing the Medical Plans

24 Retiree Health Savings Plan (HSP) Blue 65 PPO Cochlear Implants Obesity Surgery*** Vision In-Network Out-of-Network In-Network and Out-of-Network Not Covered Not Covered Covered Not Covered Not Covered Up to $60,000 lifetime limit Durable Medical Equipment (DME) Routine eye exams are covered once every 24 months with applicable copay. Discounts on hardware/frames/contacts are available at participating eye centers. You are subject to the annual deductible and coinsurance if you go out-of-network in the Blue 65 PPO. Prescription Drug Deductible Included in overall plan deductible ($2,000 individual / $4,000 family) N/A Prescription Out-of-Pocket Maximum Individual Combined with medical $3,600 Family Combined with medical $7,200 Preventive Drugs Covered at 100% Retail Prescription Drugs Generic Subject to coinsurance 10% Coinsurance (Minimum $15, Maximum $30) 30-day supply Brand Formulary 20% Coinsurance (Minimum $30, Maximum $50) 30-day supply Brand Non- Formulary 25% Coinsurance (Minimum $60, Maximum $100) 30-day supply Mail-Order Prescription Drugs Generic Vacation Exception Additional 30-day supply one time per year 10% Coinsurance (Minimum $37.50, Maximum $75) 90-day supply Brand Formulary Add vacation exception Additional 30-day supply one time per year 20% Coinsurance (Minimum $75, Maximum $125) 90-day supply Brand Non- Formulary 25% Coinsurance (Minimum $150, Maximum $250) 90-day supply *** Notification is required six months prior to surgery. Please contact UHC for plan details. To review 2017 contribution rates for Retiree Medical Coverage, please refer to Comparing the Medical Plans 24

25 YOUR PRESCRIPTION DRUG BENEFITS Coverage for Retirees When you enroll in the Retiree HSP or the Blue 65 PPO medical plan option, you are automatically enrolled in the prescription drug coverage through CVS Caremark. You have access to prescription medications through both retail pharmacies and a mail-order program. Under the prescription plan, generic, brand formulary and brand non-formulary drugs are paid by fixed percentage of the total cost each time you fill a prescription with caps to limit the amount you will spend on a prescription, referred to as a maximum. 25 Your Prescription Drug Benefits

26 Coverage for GW HSP Participants When you enroll in the Retiree HSP, you are automatically enrolled in the prescription drug coverage below through CVS Caremark. You have access to prescription medications through both retail pharmacies and a mail-order program. You must pay all out-of-pocket costs for prescription drugs until you meet your annual deductible (combined with medical, please see chart on page 27). After you meet the deductible, you will be responsible for 20% in-network coinsurance until you reach the out-of-pocket maximum. Please see chart on page 22 for additional details. You can use your HSA to pay for your prescriptions. Preventive medications are covered at 100% and the deductible and coinsurance do not apply. To review a list of preventive drugs please visit Tip It s a good idea to occasionally check up on your medications coverage tier (generic, brand formulary and brand non-formulary) as sometimes drugs change tiers. To be certain which tier your medication is on, call CVS Caremark at (877) , visit or download the CVS Caremark Mobile App. Your Prescription Drug Benefits 26

27 CHOOSING YOUR MEDICAL PLAN(S) - EXAMPLES George and Martha EXAMPLE 1: Status: George, a Retiree, is Medicare eligible; however, his spouse Martha is not Medicare eligible. Plan: George would like to enroll himself and Martha in medical coverage during Open Enrollment. George would need to choose Retiree Only coverage under UHC BLUE 65 PPO for himself and choose Spouse Only coverage under the Retiree HSP for Martha. EXAMPLE 2: Status: Neither George, a Retiree, nor Martha, his spouse, is Medicare eligible. Plan: George would like to enroll both himself and Martha in medical coverage during Open Enrollment. George would need to choose Retiree + One coverage under the Retiree HSP. EXAMPLE 3: Status: George, a Retiree, and Martha, his spouse, are both Medicare eligible. Plan: George would like to enroll both himself and Martha in medical coverage during Open Enrollment. George would need to choose Retiree + One coverage under the UHC BLUE 65 PPO plan. EXAMPLE 4: Status: George, a Retiree, and his spouse Martha are both Medicare eligible. Plan: They have two dependent children who are not Medicare eligible. George would like to enroll himself, Martha, and their children in medical coverage during Open Enrollment. George would need to choose Retiree + One coverage under the UHC BLUE 65 PPO plan for himself and Martha as well as 2 Children Only coverage under the Retiree HSP for their two children. If you are a retired employee age 65 or older and are not enrolled in Medicare Part B, the GW plan will apply the deductibles, copayments and other plan limits and pay the remaining charges minus what Medicare Part B would have paid. You will be responsible for any charges not covered by the GW plan. Please refer to your medical plan s SPD for additional details on Coordination of Benefits with Medicare. If you are eligible for Medicare Part B and visit a provider who has opted out of Medicare, the GW plan will estimate the allowable expense based on usual, customary and reasonable charges, and pay as if this allowable expense was covered by Medicare. In other words, if you visit a provider who has opted out of Medicare, the GW plan will pay only a small portion of the charges. 27 Choosing Your Medical Plan(s) - Examples

28 YOUR VISION COVERAGE OPTIONS Caring for your eyes and keeping your eyesight healthy will benefit you in all aspects of life. All Retirees are eligible to choose from voluntary vision plans. UHC VOLUNTARY VISION PLAN OPTIONS: BASIC PLAN VS. ENHANCED PLAN GW offers a choice of voluntary vision plans through UnitedHealthcare (UHC). Basic Copays for In-Network Services Exam $0 $0 Enhanced Materials $20 $20 Take a look at the table to evaluate which of the options may be right for you. Benefit Frequency Comprehensive Exam Once every 12 months Once every 12 months Spectacle Lenses Once every 12 months Once every 12 months Frames Once every 24 months Once every 12 months Contact Lenses in Lieu of Eye Glasses Frame Benefit Once every 12 months Once every 12 months Private Practice Provider $130 $130 Retail Chain Provider $130 $130 Lens Options For both the basic and enhanced plans, standard scratch-resistant coating lenses are covered in full. (Discount varies by provider.) The Enhanced Plan covers the following additional lens options in full: standard progressive lenses, standard anti-reflective coating, polycarbonate lenses, ultraviolet coating, glass coating, tints. Contact Lens Benefit Covered-in-full elective contact lenses: The fitting/evaluation fees, contact lenses and up to two follow-up visits are covered in full (after copay). If you choose disposable contacts, up to four boxes are included when obtained from a network provider. For the Enhanced Plan, up to six boxes are covered. Laser Vision Benefit UnitedHealthcare Vision has partnered with the Laser Vision Network of America (LVNA) to provide our members with access to discounted laser vision correction providers. Members receive 15% off usual and customary pricing, 5% off promotional pricing at over 500 network provider locations and even greater discounts through set pricing at LasikPlus locations. For more information, call or visit us at Out-of-network benefits are available with fixed reimbursement directly to you after submission of legible, detailed paid-in-full receipt. (Please be sure to include your ID number, name, home address, and patient s name and date of birth with claim submission.) 28 Your Vision Coverage Options Please note: You will incur less out-of-pocket expense if you see an in-network vision provider. To find an in-network vision provider, please visit

29 DID YOU KNOW? Nearly 1 out of every 2 adults experience at least one chronic condition, many of which an eye exam can help diagnose. In-network, covered-in-full benefits (after applicable copay) include: a comprehensive exam lined bifocal or lined trifocal lenses eye glasses with standard single vision standard scratch-resistant coating and the frame or contact lenses in lieu of eye glasses Refer to the chart on the previous page, it provides a summary of some of the in-network services and costs. Getting an eye exam plays a critical role in your overall health! Learn more about the vision options available: edu/vision-benefits Please visit for additional details. Your Vision Coverage Options 29

30 YOUR DENTAL COVERAGE OPTIONS Caring for your teeth and keeping your smile healthy can help ensure the rest of your body stays healthy as well. Retirees are eligible to choose from three dental plan options. The GW dental plans are stand-alone plans, so you can enroll in dental coverage whether or not you have medical coverage through GW. AETNA DENTAL PPO PLANS HIGH AND LOW OPTIONS GW offers a choice of three voluntary dental plans through Aetna. Review and compare the details below to find out which option may be right for you. As with any PPO plan, the Aetna Dental PPO plans are designed to provide you with a greater level of coverage for using service providers within the Aetna network. Some coverage is available for providers outside the Aetna network; however any services you receive from an outof-network provider will be paid only at the Reasonable and Customary amount. The High Option provides you with a greater level of coverage, and therefore carries a higher premium. The Low Option provides you with preventive and basic coverage and has a lower premium. Take a look at the table below to evaluate which of the PPO options may be right for you. Percentages in the accompanying chart represent the percentages of the negotiated amounts (in-network) and reasonable and customary amounts (out-of-network) covered by the plan. High Option Dental PPO Low Option Dental PPO In-Network Out-of-Network In-Network Out-of-Network Annual Deductible (Individual) $50 $50 $50 $50 Annual Deductible (Per Family) $50 (Max 3 per family) $50 (Max 3 per family) $50 (Max 3 per family) $50 (Max 3 per family) Annual Maximum Coverage* (Per Person Per Year Combined In- and Out-of-Network) $1,500 $1,500 $1,000 $1,000 Take a look at the table to evaluate which of the PPO options may be right for you. Preventive Care** oral examinations, cleanings, x-rays, etc. Basic Care** silver/composite fillings, root canals, stainless steel crowns, some extractions, some oral surgery, general anesthesia, etc. Major Care** inlays, onlays, crowns, full & partial dentures, denture repairs, pontics, implants*** core buildup, etc. 100% 100% 100% 100% 90% 80% 80% 70% 50% 50% Not Covered Not Covered Orthodontia (Children only combined in- and out-of-network) 50% (Lifetime max $1,500) 50% (Lifetime max $1,500) Not Covered Not Covered * Under the Aetna PPO High or Aetna PPO Low plans, preventive care services do not apply toward your annual maximum. ** Services shown are a partial list. For a complete list, see your Dental Plan Benefits Summary, available at *** Implants are covered under the PPO High Option Only. 30 Your Dental Coverage Options To review 2017 contribution rates for Dental Coverage, please refer to page 34.

31 DID YOU KNOW? Aetna Dental Maintenance Organization (DMO) You also have the option of selecting coverage If your PCD believes you need to visit a dental through the Aetna DMO, which provides benefits specialist, he or she will refer you to a specialist in in a similar manner to an HMO medical plan. the DMO network. You must elect a Primary Care Dentist (PCD) from The DMO does not provide coverage outside the within the Aetna network to coordinate all your Aetna network. There is no deductible to meet dental care. under the DMO, nor is there an annual maximum coverage amount. Office visits require a $5 copay. To be effective on the first of the month, Primary Care Dentist (PCD) selections must be received Orthodontic services are available for both adults by Aetna by the 15th of the month prior. In order and children, and require a $2,300 copay. to schedule an appointment with your PCD, your name must appear on his/her monthly roster. Preventive dental care can help reduce health risks. Periodontal disease has been linked to heart disease, diabetes and preterm birth. REASONABLE AND CUSTOMARY: Dental providers who participate in the Aetna network have agreed to accept a standard level of payment for their services. This is called the Negotiated amount. Providers who are not in the network may charge more than the Reasonable and Customary amount, however, your coverage will not pay more than that amount. You will be responsible for the difference. Your Dental Coverage Options 31

32 LIFE INSURANCE Active faculty and staff receive group term life insurance in an amount equal to their annualized salary, rounded to the next highest thousand dollars. The maximum amount of coverage is one times salary or $500,000, whichever is less. Please note: age reduction provisions apply for active employees age 70 and older. Please see the life insurance certificate for details. On your retirement date, the life insurance coverage is reduced to 80% of the life insurance in effect on your last full day of active work, rounded up to the nearest $1,000. On July 1 coinciding with or next following the anniversary of retirement, the life insurance coverage is reduced to 60% of the life insurance in effect on your last full day of active work (not rounded), or $2,500 if age 70 On July 1 coinciding with or next following the second anniversary of retirement, the life insurance coverage is reduced to 40% of the life insurance in effect on your last full day of active work (not rounded) or $2,500 if age 70 On July 1 coinciding with or next following the third anniversary of retirement, the life insurance coverage is reduced to 20% of the life insurance in effect on your last full day of active work (not rounded) or $2,500 if age 70 On July 1 coinciding with or next following the fourth anniversary of retirement, the life insurance coverage is reduced to $2,500 Example 1: An employee with a life insurance benefit of $104,000 prior to retirement at age 60: On the date of retirement the benefit reduces to $84,000 On July 1 following the 1st anniversary of retirement the benefit reduces to $62,400 On July 1 following the 2nd anniversary of retirement the benefit reduces to $41,600 On July 1 following the 3rd anniversary of retirement the benefit reduces to $20,800 On July 1 following the 4th anniversary of retirement the benefit reduces to $2,500 Example 2: An employee with a life insurance benefit of $104,000 prior to retirement at age 68: On the date of retirement the benefit reduces to $84,000 (age 68) On July 1 following the 1st anniversary of retirement the benefit reduces to $62,400 (age 69) On July 1 following the 2nd anniversary of retirement the benefit reduces to $2,500 (age 70) Premiums for retiree group term life insurance are fully paid by the university. Premiums paid by GW for benefits in excess of $50,000 are taxable to active employees and to retirees, and are reported on form W-2 each year. While you are an active employee, this information appears on your regular W-2 from GW. Once you are retired GW will generate and mail to you a special W-2 for the purposes of reporting this benefit. For additional details on the coverage available (including age reduction provisions), and to determine when EOI applies, please visit 32 Life Insurance

33 CONTRIBUTION RATES To review the 2017 Retiree Medical Contribution Rates, please visit (Scroll down and select "Retirees"). Dental Coverage Coverage Categories Monthly DMO Retiree Only $21.64 Retiree + One $49.45 Retiree + Family $59.84 High PPO Retiree Only $53.05 Retiree + One Dependent $ Retiree + Family $ Low PPO Retiree Only $31.74 Retiree + One Dependent $67.44 Retiree + Family $81.64 UHC Vision Coverage Coverage Categories Monthly Basic Retiree Only $4.99 Retiree + One $9.24 Retiree + Family $14.73 Enhanced Retiree Only $7.24 Retiree + One Dependent $13.40 Retiree + Family $21.36 Dental and UHC Vision Coverage 33

34 Plan Discover Learn Explore Compare Decide DECIDE 34 Page Info Name

35 HOW TO ENROLL To make the most of your GW benefits, you ll need to make informed choices using the information in this guide. You will receive an enrollment packet from PayFlex. PayFlex will be mailing you an Open Enrollment packet. Included in this packet will be a cover letter and an enrollment form. ENROLLMENT DEADLINE November 15, 2016 is the LAST day to make changes for Remember: Open Enrollment is the only time you can make changes to your benefits or covered dependents unless you have a qualified life event. Please be sure to review this information, change or select new benefits, and return your completed information to PayFlex. Please note: Your enrollment form must be returned to PayFlex and postmarked no later than November 15, If you have any questions regarding the enrollment process, premiums, or billing, please contact PayFlex at (800) , visit or send correspondence to the address below: PayFlex Systems USA, Inc. P.O. Box St. Louis, MO Reminder: All of your eligible 2016 benefit elections (medical, dental, and vision) will roll over to 2017; if you are currently in the Choice Plus Basic Plan, you will be automatically enrolled in the Retiree HSP. If you do not wish to make any changes, no action is needed; however, we do recommend that you review your current elections to ensure they still provide the coverage you need. Please remember that changes made during this period become effective January 1, ADDING A DEPENDENT If adding a dependent for the first time, submit your dependent documentation to the GW Benefits Administration Department, Research Place, Suite 160, Ashburn, VA by Wednesday, November 30, Please note that dependent enrollment is pending until documentation is received and verified. Please note that if you choose not to continue medical coverage, you will not be eligible to participate in the GW medical plan in the future. Please contact the GW Benefits Call Center at (888) 4GWUBEN ( ) with any questions you have during the Open Enrollment period. Using the EasyEnroll System 35

36 IMPORTANT CONTACT INFORMATION Who to Call Medical UnitedHealthcare (Customer Service & Nurseline) Dental Contact Information Nurseline: (800) Plan Information (if applicable) Group# Aetna Group# Prescription Drug CVS Caremark Vision UnitedHealthcare Vision FastStart for maintenance prescriptions Customer Service: Provider Locator: Group# RX6475 Enrollment Process, Premiums and Billing PayFlex Retirement Plans Fidelity Investments TIAA-CREF Life Insurance The Standard Number: Wellness Benefits Wellbeing Hotline Health Advocate go.gwu.edu/well healthadvocate.com/gwu 36 Important Contact Information

37 IMPORTANT CONTACT INFORMATION Who to Call Contact Information GW Departments Benefits Call Center 888-4GWUBEN ( ) Benefits Administration Department Important Contact Information 37